Department of Cardiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
Department of Internal Medicine II, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
Medicina (Kaunas). 2019 Sep 5;55(9):569. doi: 10.3390/medicina55090569.
: The comorbid association between type 2 diabetes mellitus (T2DM) and a psychological profile characterized by depression and/or anxiety has been reported to increase the risk of coronary heart disease (CAD), the most striking macrovascular complication of diabetes. The purpose of the present study was to quantify anxiety, depression and the presence of type D personality, and to correlate the scores obtained with cardiovascular risk factors and disease severity in diabetic patients The retrospective study included 169 clinically stable diabetic patients divided into two groups: group 1 without macrovascular complications ( = 107) and group 2 with CAD, stroke and/or peripheral vascular disease ( = 62). A biochemical analysis and an assessment of psychic stress by applying the Hospital Anxiety and Depression Scale (HADS)and the Type D scale (DS-14) to determine anxiety, depression and D personality scores were done in all patients. Statistical analysis was made using SPSSv17 and Microsoft Excel, non-parametric Kruskal-Wallis and Mann-Whitney tests. Following application of the HAD questionnaire for the entire group ( = 169), anxiety was present in 105 patients (62.2%), and depression in 96 patients (56.8%). Group 2 showed significantly higher anxiety scores compared to group 1 ( = 0.014), while depression scores were not significantly different. Per entire group, analysis of DS-14 scores revealed social inhibition (SI) present in 56 patients (33%) and negative affectivity (NA) in 105 patients (62%). TheDS-14 SI score was significantly higher in group 2 compared to group 1 ( = 0.036). Type D personality, resulting from scores above 10 in both DS-14 parameter categories, was present in 51 patients of the study group (30%). There was a direct and significant correlation ( = 0.133, = 0.025) between the Hospital Anxiety and Depression Scale-Anxiety (HAD-A) score and the LDL-c values. The results of this study demonstrated that more than a half of patients with diabetes had anxiety and/or depression and one third had Type D personality, sustaining that monitoring of emotional state and depression should be included in the therapeutic plan of these patients. New treatment strategies are needed to improve the well-being of diabetic patients with psychological comorbidities.
：2 型糖尿病（T2DM）与以抑郁和/或焦虑为特征的心理特征之间的合并关联已被报道会增加冠心病（CAD）的风险，这是糖尿病最显著的大血管并发症。本研究的目的是量化焦虑、抑郁和 D 型人格的存在，并将获得的分数与糖尿病患者的心血管危险因素和疾病严重程度相关联。这项回顾性研究包括 169 名临床稳定的糖尿病患者，分为两组：无大血管并发症的第 1 组（n=107）和患有 CAD、中风和/或外周血管疾病的第 2 组（n=62）。对所有患者进行生化分析和应用医院焦虑抑郁量表（HADS）和 D 型量表（DS-14）评估心理压力，以确定焦虑、抑郁和 D 型人格得分。统计分析使用 SPSSv17 和 Microsoft Excel，非参数 Kruskal-Wallis 和 Mann-Whitney 检验。对整个组（n=169）应用 HAD 问卷后，105 名患者（62.2%）存在焦虑，96 名患者（56.8%）存在抑郁。第 2 组的焦虑评分明显高于第 1 组（=0.014），而抑郁评分无明显差异。对整个组进行 DS-14 评分分析显示，社会抑制（SI）在 56 名患者（33%）中存在，负性情绪（NA）在 105 名患者（62%）中存在。DS-14 SI 评分在第 2 组明显高于第 1 组（=0.036）。DS-14 两个参数类别得分均高于 10 分的 D 型人格，在研究组 51 名患者中存在（30%）。HAD 焦虑量表（HAD-A）评分与 LDL-c 值之间存在直接且显著的相关性（=0.133，=0.025）。本研究结果表明，超过一半的糖尿病患者存在焦虑和/或抑郁，三分之一的患者存在 D 型人格，这表明应将情绪状态和抑郁监测纳入这些患者的治疗计划。需要新的治疗策略来改善有心理合并症的糖尿病患者的幸福感。
